Objectives: Incidence rates of testicular cancer are increasing among
postpubescent men. This suggests that putative exposures may operate e
arly in life and have changed over time. The age at which endocrine ac
tivity accelerates (age at puberty) may be such an exposure. This stud
y was undertaken to investigate the relationship between age at pubert
y and testicular cancer risk. Methods: A population-based case-control
study was conducted in the province of Ontario, Canada which included
males, aged 16 to 59 years, diagnosed with testicular germ cell cance
r between 1987 and 1989, and age-matched controls. Data were collected
on 502 cases, 346 case mothers, 975 controls, and 522 control mothers
. Surrogate measures for age at puberty included age at starting ro sh
ave, appearance of hair, growth spurt, and voice change. Results: A pr
otective effect of later puberty was evident for all four measures of
puberty as reported by both subjects and mothers, and greater protecti
on was conferred when the greatest number of later puberty events were
reported. Risk associated with earlier puberty was inconclusive. Conc
lusions: As age at puberty is decreasing in the population, the propor
tion of boys experiencing the protective effect of later puberty may b
e diminishing. This may help explain the increasing incidence of testi
cular cancer.